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DERM 1 > General Patton- Bullous and Melanocytic Dz > Flashcards

General Patton- Bullous and Melanocytic Dz Flashcards

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Dermatology Board Prep flashcards
1
Q

Which subtype of melanoma is most likely to be present for a long time before being diagnosed?

A

Lentigo maligna melanoma

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2
Q

Involvement of what structues concurrent with congenital nevi carries a poor prognosis (regardless of malignant transformation)?

A

leptomeninges (pia and arachnoid)

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2
Q

What is the big issue with mucous membrane pemphigoid?

A

It results in scarring at whatever mucosal sites it involves (corneal blindness, esophageal stenosis, laryngeal stenosis)

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3
Q

Name 2 genes that have mutations which predispose to melanoma

A

CDKN2A and BRAF

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4
Q

What are vemurafinib and dabrafenib?

A

BRAF inhibitors for Tx of melanoma

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4
Q

What is the most common immunobullous disease?

A

bullous pemphigoid

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5
Q

What is the most common subtype of melanoma?

A

superficial spreading

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5
Q

MOA of ipilimumab

A

binds CTLA4 to disinhibit T cells for Tx of melanoma

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5
Q

What is the Tx of Linear IgA disease when not caused by an underlying drug problem?

A

Dapsone

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5
Q

What is the DOC for dermatitis herpetiformis?

A

dapsone but for long-term they need the gluten free diet

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6
Q

What drug binds CTLA-4

A

Ipilimumab

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7
Q

What is the most common malignancy associated with paraneoplastic pemphigus?

A

Non-Hodgkin’s lymphoma

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8
Q

Autoantibodies to what kind of structures are present in the pemphigus group of immunobullous diseases?

A

desmosomes

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9
Q

How is the Tx of mucous membrane pemphigoid different from that of bullous pemphigoid and pemphigus vulgaris?

A

Mucous membrane pemphigoid involves more rigorous tx not only with corticosteroids but also cyclophosphamide because of the serious sequela that can occur

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9
Q

T/F: most patients with dermatitis hepetiformis have celiac sprue

A

False? ALL patients with dermatitis herpetiformis have celiac sprue

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10
Q

What must you work up a patient for if they have porphyria cutanea tarda?

A

liver disease

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11
Q

What immunobullous disease is treated with dapsone?

A

Linear IgA disease that is NOT associated with drugs, if it is then the Tx is to remove the drug; dermatitis herpetiformis

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12
Q

What are the autoantibodies against in pemphigus vulgaris? Bullous pemphigoid?

A

Pemphigus vulgaris = desmoglein of desmosomes; bullous pemphigoid = BPAg1 and 2

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12
Q

What is the most common cause of Linear IgA disease?

A

Vancomycin and other drugs

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14
Q

What dermatologic disease can rituximab (anti-CD21) be used to Tx?

A

Pemphigus vulgaris

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14
Q

What is the Tx of Linear IgA disease?

A

Removal of the offending agent

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15
Q

What is a nevus that is present at birth?

A

Congenital nevus. OMG brain-usage

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17
Q

What are the autoantibodies targeting in bullous pemphigoid?

A

BPAg 1 and 2 (Bullous pemphigoid antigen 1 and 2)

18
Q

Which type of melanoma has the highest rate of metastasis?

A

Nodular melanoma (because it grows down into skin and staging is by depth of invasion)

18
Q

What are the steroid-sparing therapies for pemphigus vulgaris?

A

mycophenolate mofetil or azathioprine (and rituximab)

19
Q

How does Dr. Hussein pronounce “occur”?

A

Oak-hair

20
Q

What is a nevus that occurs in childhood or adulthood called?

A

A benign acquired nevus

22
Q

Compare and contrast the Tx of bullous pemphigoid and pemphigus vulgaris

A

They are actually the same? First use corticosteroids and follow up with steroid sparing drugs (mycophenolate moxetil and azathioprine) once under control. BUT rituximab seems to be reserved only for pemphigus vulgaris

24
Q

What demographic experiences the highest mortality rates with melanoma?

A

older men

25
Q

Which type of melanoma contains no pigmentation?

A

amelanotic

26
Q

What is the autoantigen in epidermolysis bullosa acquisita?

A

Type VII collagen

28
Q

What are the 3 diseases under the pemphigus grouping?

A

Pemphigus vulgaris, Pemphigus foliaceous, and Paraneoplastic pemphigus

30
Q

T/F: nuclear atypia in a dysplastic nevus is associated with a clinically benign outcome

A

True, dysplastic nevi are treated as benign conditions

31
Q

Where do melanomas most often arise?

A

In areas of skin where a nevus was not previously present

33
Q

Which porphyria can be acquired with liver failure and HIV?

A

porphyria cutanea tarda

34
Q

Name the 2 BRAF inhibitors for melanoma

A

vemurafinib and dabrafenib

35
Q

What is the best way to remove a suspicious looking mole?

A

elliptical excision (as opposed to shave, saucerization, or punch)

36
Q

What clinical sign can dermatologists use to tell which of a group of nevi is most likely to be melanoma

A

The Ugly Duckling sign–and these people need the highest board scores of all

37
Q

MOA of trametinib

A

Inhibits MEK when treating Melanoam

39
Q

Where are the lesions in pemphigus vulgaris?

A

In the mouth and skin? Bullous pemphigoid really does not involve the mouth unless it is just mucous membrane pemphigoid

40
Q

T/F: sentinal lymph node biopsy is a therapeutic procedure for mgmt of melanoma

A

False, it is done to obtain prognostic information

41
Q

What color are Spitz nevi?

A

pink to red

42
Q

Enzyme deficient in porphyria cutanea tarda

A

uroporphyrinogen decarboxylase; note, in case of distractor that acute intermittent porphyria is urobilinogen deaminase

43
Q

When Txing melanoma, what drug inhibits MEK?

A

Trametinib

44
Q

This disease involves autoantibodies against type VII collagen

A

Epidermolysis bullosa acquisita NOT the hereditary epidermolysis bullosa

45
Q

How is pemphigus foliaceous different from pemphigus vulgaris?

A

It is not as severe and they do NOT develop oral lesions

46
Q

Which type of melanoma occurs mostly in African American, Africans, and Asians?

A

Acral lentiginous melanoma

47
Q

When is there a risk of melanoma in congenital nevi?

A

If they are very large

48
Q

How do you tx porphyria cutanea tarda?

A

phlebotomy, the underlying cause is excess iron i.e. alcoholic cirrhosis, hemochromatosis and hepatocellular carcinoma? also LOW DOSE CHLOROQUINE

50
Q

What is the mainstay of Tx for pemphigus vulgaris?

A

Corticosteroids

51
Q

After removal of a melanoma, what dictates the next step in its management?

A

The thickness of the original tumor

52
Q

How is the oral disease of paraneoplastic pemphius different from pemphigus vulgaris and foliaceous?

A

It is the most severe and pemphigus foliaceous doesn?t have oral involvement anyway

53
Q

If melanoma occurs in a congenital nevus, when is the earliest that is likely to occur?

A

puberty

54
Q

T/F: one can make the diagnosis of dysplastic nevus clinically

A

nope, dysplastic nevus is a histological Dx

55
Q

What are the autoantibodies targeting in pemphigus vulgaris?

A

desmoglein of desmosomes

DERM 1 (7 decks)

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